A case of aortic valve replacement for aortic insufficiency complicated with enterococcal endocarditis in a patient with systemic lupus erythematosus (SLE) is described. The cardiac complications of SLE may involve the endocardium, myocardium, pericardium, and coronary vessels. Steroids which are used for treatment probably increase the incidence of valve incompetence. Aortic insufficiency or infective endocarditis complicating Libman-Sacks endocarditis is rarely observed and may require valve replacement. Echocardiography is an important diagnostic tool. Renal function, pulmonary status, and cerebral complications require special attention in these patients.